Celecoxib: Difference between revisions
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{{MedTemplate | {{MedTemplate | ||
| generic = Celecoxib | | generic = Celecoxib | ||
| brand | | brand = Celebrex (oral capsules), Elyxyb (oral solution, for acute migraine) | ||
| classes = NSAID, COX-2 | | structure = | ||
| | | classes = [[:Category:NSAIDs|Non-steroidal anti-inflammatory (NSAID, selective COX-2)]], [[:Category:Analgesics|Analgesic]] | ||
| uses = <vote slug="osteoarthritis-use">Osteoarthritis (FDA)</vote>, <vote slug="rheumatoid-arthritis-use">Rheumatoid arthritis (FDA)</vote>, <vote slug="juvenile-ra-use">Juvenile rheumatoid arthritis (FDA, ≥2 years)</vote>, <vote slug="ankylosing-spondylitis-use">Ankylosing spondylitis (FDA)</vote>, <vote slug="acute-pain-celecoxib-use">Acute musculoskeletal pain (FDA)</vote>, <vote slug="dysmenorrhea-use">Primary dysmenorrhea (FDA)</vote>, <vote slug="fap-adjunct-use">Familial adenomatous polyposis (FDA, adjunct to surgery and surveillance)</vote>, <vote slug="acute-migraine-celecoxib-use">Acute migraine (Elyxyb oral solution, FDA)</vote> | |||
| starting_dose = Osteoarthritis: 200 mg PO once daily or 100 mg BID. Rheumatoid arthritis: 100-200 mg PO BID. Acute pain: 400 mg loading, then 200 mg every 12 hours | |||
| preparations = Capsules 50, 100, 200, 400 mg; Elyxyb oral solution 25 mg/mL | |||
| fda_max = 400 mg/day for chronic indications; higher for short-term acute pain | |||
| pill_id = | |||
| routes = Oral | |||
| onset = 30-60 minutes | |||
| duration = 12-24 hours | |||
| halflife = ~11 hours<ref name="celebrex-label">FDA Prescribing Information, Celebrex (celecoxib), Pfizer, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020998s053lbl.pdf</ref> | |||
| bioavailability = ~99% (oral)<ref name="celebrex-label" /> | |||
| pregnancy = Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)<ref name="celebrex-label" /> | |||
| legal = [[USLegal:Prescription only|Rx-only]] in US | |||
| mechanism = <vote slug="celecoxib-mech-claim">Selective COX-2 inhibitor, the only such NSAID in widespread US use after the withdrawals of rofecoxib (Vioxx, 2004) and valdecoxib (Bextra, 2005). COX-2 selectivity reduces gastrointestinal mucosal injury compared to non-selective NSAIDs, the principal pharmacological selling point, while the PRECISION trial (2016) demonstrated cardiovascular non-inferiority versus ibuprofen and naproxen, validating continued use.</vote> CYP2C9 substrate; CYP2C9 poor metabolizers may have higher exposure and benefit from a lower starting dose. Contains a sulfonamide moiety that has historically prompted caution in patients with sulfa antibiotic allergy, though the chemistry differs from antimicrobial sulfonamides and cross-reactivity is debated<ref name="celebrex-label" />. | |||
}} | }} | ||
== References == | |||
<references /> | |||
[[Category:NSAIDs]] | |||
[[Category:Analgesics]] | |||
Latest revision as of 07:01, 23 May 2026
Celecoxib
Celebrex (oral capsules), Elyxyb (oral solution, for acute migraine)
Experience
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Summary
Common uses
Osteoarthritis (FDA)0, Rheumatoid arthritis (FDA)0, Juvenile rheumatoid arthritis (FDA, ≥2 years)0, Ankylosing spondylitis (FDA)0, Acute musculoskeletal pain (FDA)0, Primary dysmenorrhea (FDA)0, Familial adenomatous polyposis (FDA, adjunct to surgery and surveillance)0, Acute migraine (Elyxyb oral solution, FDA)0
Pharmacy
Starting dose
Osteoarthritis: 200 mg PO once daily or 100 mg BID. Rheumatoid arthritis: 100-200 mg PO BID. Acute pain: 400 mg loading, then 200 mg every 12 hours
Preparations
Capsules 50, 100, 200, 400 mg; Elyxyb oral solution 25 mg/mL
US FDA Max
400 mg/day for chronic indications; higher for short-term acute pain
Pharmacology
Routes
Oral
Onset
30-60 minutes
Duration
12-24 hours
Half-life
~11 hours[1]
Bioavailability
~99% (oral)[1]
Pregnancy
Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)[1]
Legal status
Rx-only in US
Purported mechanism
Selective COX-2 inhibitor, the only such NSAID in widespread US use after the withdrawals of rofecoxib (Vioxx, 2004) and valdecoxib (Bextra, 2005). COX-2 selectivity reduces gastrointestinal mucosal injury compared to non-selective NSAIDs, the principal pharmacological selling point, while the PRECISION trial (2016) demonstrated cardiovascular non-inferiority versus ibuprofen and naproxen, validating continued use.0 CYP2C9 substrate; CYP2C9 poor metabolizers may have higher exposure and benefit from a lower starting dose. Contains a sulfonamide moiety that has historically prompted caution in patients with sulfa antibiotic allergy, though the chemistry differs from antimicrobial sulfonamides and cross-reactivity is debated[1].
References
- ↑ 1.0 1.1 1.2 1.3 FDA Prescribing Information, Celebrex (celecoxib), Pfizer, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020998s053lbl.pdf